Comparison of Effectiveness of Dexmedetomidine and Tramadol in the Treatment of Post-Neuraxial Anaesthesia Shivering

Abstract

Background: Shivering is a common problem encountered after neuraxial anaesthesia and is most likely due to altered afferent thermal input from the blocked region. Tramadol a centrally acting analgesic drug, is effective in the treatment of post-anaesthetic shivering after general and neuraxial anaesthesia, by inhibiting the neuronal reuptake of noradrenaline and 5-hydroxytryptamine (5-HT), facilitates 5-HT release and activates the μ-opioid receptors. Dexmedetomidine, a potent alpha 2-adrenergic receptor agonist, acts by decreasing the vasoconstriction and is known to reduce the shivering threshold. Materials & Methods: This was a prospective, randomised, double-blinded study included 100 patients of either genders, aged 20–65 years with ASA status I-II scheduled to undergo elective surgery under spinal anaesthesia. They were then randomly allocated to receive either intravenous dexmedetomidine 0.5 μg/kg or tramadol 0.5 mg/kg. The response rate to treatment, the degree of sedation and the side-effects were recorded. Results: The response rate to treatment and bradycardia was more in the dexmedetomidine group, whereas, nausea and vomiting were observed more in tramadol group and diferrence was significant when compared between groups. Sedation score was comparable between two groups. Conclusion: Dexmedetomidine is superior to tramadol for shivering treatment, due to higher effective rate of shivering control, earlier onset of action and lesser recurrence of shivering and lower incidences of nausea and vomiting. However, dexmedetomidine is also associated with higher incidences of hypotension and bradycardia than tramadol.